title: Hoarseness evaluation: a transatlantic survey of laryngeal experts.
abstract: OBJECTIVE
  Hoarseness is a symptom of laryngeal dysfunction, without an existing consensus regarding its appropriate evaluation. A survey of laryngeal specialists is proposed to establish expert opinion on the methodology for evaluation of hoarseness, and to identify divergence of opinion regarding appropriate management.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A 13-item questionnaire was submitted electronically to the membership of the American Laryngological Association, the American Broncho-Esophagological Association, and the European Laryngological Society. Responses were collated anonymously and subjected to cross-tabulated data analysis.
  
  
  RESULTS
  A total of 195 responses were included for review. The majority of respondents identified themselves as laryngologists/phoniatricians (54.9%). Two-thirds (64.1%) of the providers dedicated more than 25% of their practice to voice management, and 48.8% managed more than 10 dysphonic patients weekly. Most respondents defined hoarseness and dysphonia as symptoms and not diseases. The panel recommended a mandated time to laryngoscopy of 1 week to 1 month from the onset of symptoms for most acutely dysphonic patients, regardless of risk factors for malignancy, while it was not advised to defer laryngoscopy beyond 2 months of symptom persistence in any situation. A majority (96.2%) felt that an otolaryngologist ought to perform the initial laryngoscopy of a newly hoarse patient.
  
  
  CONCLUSIONS
  This survey demonstrates an agreement to expedite specialized laryngeal visualization for cases of hoarseness not subsiding within 1 month, and exemplifies controversies stemming from a recently published clinical practice guideline. Ongoing research and practice evaluation will contribute to set forth improved standards of care and to appropriately counsel dysphonic patients.
authors.affiliation: New York Center for Voice and Swallowing Disorders, St. Luke's-Roosevelt Hospital Center, Weill Cornell Medical College, New York, New York.
authors.forename: Babak
authors.initials: B
authors.lastname: Sadoughi
authors.forename: Marvin P
authors.initials: MP
authors.lastname: Fried
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
authors.forename: Andrew
authors.initials: A
authors.lastname: Blitzer
mesh_terms: D003430:Cross-Sectional Studies; D005060:Europe; D019983:Guideline Adherence; D006685:Hoarseness / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D010036:Otolaryngology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States
keywords: Hoarseness; dysphonia; guideline; laryngoscopy